Physician self-regulation in the United States had its origin in the early 20th century when concern about the quality of medical education prompted the American Medical Association to create the Council on Medical Education in 1904. In 1908, the council contacted the Carnegie Foundation for the Advancement of Teaching to conduct a survey of North American medical schools. The Carnegie Foundation chose Abraham Flexner, a noted educational theorist and former high school principal, to lead the research. Flexner visited all 155 medical schools and issued a report in 1910.1 His report cited the lack of a formalized admissions process and no standard curriculum among major flaws. This had resulted in great variation in the quality of education and, for 25 years, an overproduction of poorly trained medical practitioners. The Flexner report stimulated the elimination of more than half of the existing medical schools and the implementation of a formal admissions process and a standardized curriculum in all remaining medical schools.